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February 10, 2020

Can We Really Stop Pediatric Migraine?Using Network Meta-analysis to Remove the Guess Work

Author Affiliations
  • 1Children's and Adolescents' Hospital Datteln, Witten/Herdecke University, German Paediatric Pain Centre, Datteln, North Rhine-Westphalia, Germany
JAMA Pediatr. Published online February 10, 2020. doi:10.1001/jamapediatrics.2019.5907

Pediatric primary headache is one of the leading health care issues in high-income countries that is rising in prevalence.1 Frequent headaches are strongly associated with a lower quality of life and poorer academic performance and are a leading cause of school absence.2 The classification system of the International Headache Society provides a navigation system to phenomenologically diagnose migraines, tension-type headaches, and other primary headaches (https://ichd-3.org/wp-content/uploads/2018/01/The-International-Classification-of-Headache-Disorders-3rd-Edition-2018.pdf); however, pediatric-specific factors have not been considered sufficiently.3

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    1 Comment for this article
    Pediatric Migraine
    Dan Spearman, MD | Private Practice
    Despite the fact that cyproheptadine has been felt to be a non-starter as the first choice for pediatric migraine, I find that in younger patients it seems to lessen the frequency and severity of the headaches, followed by amitriptyline if no improvement. I disagree that nothing helps, just from my own experience over the years.